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R257
R257 – Osteotomy - phalanx - terminal
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Osteotomy of the terminal phalanx of the hand or wrist. This is a surgical procedure listed under the Musculoskeletal System section of the Schedule of Benefits. Assistant services, suffix 'B', are not eligible for payment with this procedure. The anaesthesia service (R257C) has 6 base units. See page for details.
When to Use
- Use R257 for a formal osteotomy of the terminal phalanx when correcting a deformity or malunion, specifically distinguishing it from simple debridement or minor excisions.
- Select R257 when the procedure is limited to the terminal phalanx, as opposed to R258 which covers other phalanges or more extensive musculoskeletal work.
Common Pitfalls
- Attempting to bill a surgical assistant fee (suffix B) with R257 will result in an automatic rejection, as this code is explicitly restricted from assistant services.
- Confusing R257 with minor procedures or simple fracture reductions; ensure the operative report clearly details the osteotomy (cutting of bone) to justify the surgical fee over a lesser procedure code.
Billing Tips
- Always verify if the patient qualifies for an age-based premium (e.g., AGE_PREMIUM_LT16Y) to increase the base fee by the appropriate percentage, as these are frequently missed for pediatric hand surgeries.
- If the procedure is performed after hours for a non-elective condition, ensure you append the correct premium (E409 or E410) to the claim to capture the 50% or 75% fee increase.
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